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my %regular_hash = (
    question1 => 'How are you?',
...
    my %regular_hash = @_;
    $regular_hash{question1} = 'What is your mothers name?';
}

my $hash_rev = {   #notice the change of opening brace
    question1 => 'How are you?',
...
    my $hash_ref = shift @_;
    $hash_ref->{question1} = 'What is your mothers name?';
}